Life as this T1D knows it

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Mea culpa.

Those were the words of my endocrinologist as she entered the examination room. Not the words of kudos that I was hoping for (if not somewhat expecting). I had been using my CGM, I had been religious about taking my medication, and I had been testing my BGs more (not enough, but more). I didn’t think they would much under 8, but I didn’t think they would go up, either!

And then she proceeded to go through the test results that were not in my favor – the good ol’ standbys and some new ones. Let me recap:

Hemoglobin A1C: 8.6% (was 8.3%) [4.8-5.6%]

Serum Glucose Fasting: 229 mg/dL (was 119 mg/dL) [65-99 mg/dL]

BUN: 17 mg/dL (was 14 mg/dL) [6-24 mg/dL]

Serum Creatinine: 0.83 mg/dL (was 0.79 mg/dL) [0.57-1.00 mg/dL]

TSH: 1.880 uIU/mL (was 1.330 uIU/mL) [0.450-4.500 uIU/mL]

Total Cholesterol: 170 mg/dL (was 226 mg/dL) [100-199 mg/dL]

Triglycerides: 240 mg/dL (was 165 mg/dL) [0-149 mg/dL]

LDL Cholesterol: 70 mg/dL (was 138 mg/dL) [0-99 mg/dL]

She was very concerned about the triglycerides (diabetes and heart disease are highly correlated). Note: My cardiologist wants his patients to keep their TRG levels < 100; for his diabetic patients, he wants it to be < 70. 240 is SERIOUSLY in the wrong direction.

And then she also mentioned elevated potassium and elevated liver enzymes. Potassium can be indicative of kidney and heart function. Elevated liver enzymes can be indicative of liver function. Those have never been out of whack for me – and those are the big ones for diabetics.

Oh dear.

That’s when the rubber hit the road. Push came to shove. The you-know-what hit the fan.

And then came the tears.

You know, I knew this was coming. I have been skating through my diabetes management for the last few years, mostly focused on A1Cs. High sevens to high eights in the A1C department, with a nine something in there for (not so good) measure.

You can call it being lazy, stubborn, selfish, rebellious, whatever you want. I’m just going to call it stupid – and I’m not a stupid person. Mea culpa.

She asked me why I was tearing up, and I told her that I was disappointed in myself. And that I’ve been avoiding changing my diet and exercise routine. And that I know I have been lax (more accurately, lazy) in my self-management of my disease.

She said it was good for me to have this “aha” moment. And that this was the first step in turning this around.

She was – and is – right.

She also encouraged me to send her my BG readings and other information at any time so she can help me, rather than waiting 3 months to address any issues. (I have the best endocrinologist).

I write this now, two weeks since the appointment. I let myself feel sorry for myself for one day, I immediately made some changes to my diet, and I went on vacation. I made these pledges to myself:

I will test my blood glucose before meals, not just after. This will help me better determine how much insulin I should give myself with my meal.

I will bolus (give myself insulin) 15 minutes before I eat. This “pre-bolus” gets the insulin into your system earlier (while you are eating) and should help reduce post-meal BG spikes.

I will visit a nutritionist and get back to a healthier diet. (Less carbs, less fat, smaller meals spread throughout the day…)

I will exercise more. (Duh).

I will stop drinking wine during the week and save it for weekends only. (Double Duh).

(BTW, I know all of these things. It’s not new news to me. As I said earlier, I’ve been skating through my diabetes management for too long now).

So…

By writing this in my blog, I am pledging this not only to myself, but to you. It’s in writing and in the public domain now. I will also try to share my progress each week. I figure if I make it public, I will have additional motivation to do better (as if my health was not enough). I can do this!